Laparoscopic Retrieval of a Tilted Inferior Vena Cava Filter

Abstract

Two separate attempts aimed to remove the filter were unsuccessful, abdominal computed tomography showed the filter tilted and struts of the filter penetrating the caval wall appeared to be outside the IVC [Figure 1]a. Considering the patient's young age and long-term filter-associated complications, decision was made to remove the filter by laparoscopic surgery. The infrarenal IVC is encircled with a tourniquet, the tourniquet passed through a half-inch piece of 20-F drain catheter and secured in place with a Hem-o-lok clip [Figure 1]b. After alerting the anesthesiologist, the two tourniquets were tightly cinched sequentially (distal and proximal); the cavotomy was performed at the apex of the IVC filter to simplify grasp of the filter tip and to collapse the filter legs. [...]laparoscopic retrieval of IVC filters is a complex and technically demanding surgery.